Home
Coverage
About
Contact
CareersInterested in joining Adero? Email up your resume.

Commercial Quote Request

Commercial Quote

Business Name

Point of Contact Full Name

Phone

Email

Prefered Method of Contact

Phone

Email

State

Business Industry

Briefly describe your business operations:

Years in Business

Number of Employees

Estimated Annual Revenue

What type of insurance would you like a quote for?

General Liability

Professional Liability (Errors & Omissions)

Commercial Property

Commercial Auto

Worker’s Compensation

Trucking

Other

Please tell us about what coverage you need:

Desired Coverage Start Date

Professional Liability

Errors & Omissions

What professional services does your business provide?

How many licensed or credentialed professionals work for the business?

Estimated annual revenue from professional services?

Coverage Limits

Trucking

USDOT #

MC # (if applicable)

Type of trucking operation

Interstate or Intrastate

Number of Power Units

Number of Trailers

Number of Drivers

Operating Radius (mi)

Type of coverage needed:

Any accidents or claims in the past 3 years?

Yes

No

Commercial Auto

Business Vehicles & Drivers

How many vehicles need coverage?

Vehicle Year, Make, & Model

Type of Vehicle

Number of Drivers

Are vehicles owned, leased, or rented?

Any auto claims in the past 5 years?

Yes

No

Address

Address Line 1

Address Line 2

City

Zip Code

Desired Personal Property Coverage

Workers Compensation

Employees, payroll, and workplace risk

Number of Full-Time Employees

Number of Part-Time Employees

Do you use subcontractors?

Yes

No

Estimated annual payroll

Type of work performed

Current workers’ compensation carrier (if any)

General Liability

Business activities and liability exposure

Does your business operate from a physical address?

Yes

No

Do customers visit your business location?

Yes

No

Do you perform work at customer locations?

Yes

No

Do you use subcontractors?

Yes

No

Any liability claims in the past 5 years?

Yes

No

Requested Liability Coverage

Commercial Property

Buildings, equipment, and business content

Property Address

Address Line 1

Address Line 2

City

State

Zip Code

Do you own or lease the property?

Estimated Replacement Value

Type of Property

Year Built

Square Footage

Does the building have fire sprinklers?

Yes

No

Estimated Value of Equipment, Inventory, and Contents

Do you currently have business insurance?

Yes

No

Current Insurance Carrier

Current Policy Expiration Date

Explore

Home
Coverage
About
Contact
CareersInterested in joining Adero? Email up your resume.

Get in Touch

admin@aderoinsurance.com

Adero Insurance Group